Journal of Community Medicine & Health Education
Open Access

Abstract

Introduction: Management of a patient with a neck of femur (NOF) fracture is a key aspect of orthopedic trauma care, with around 75,000 new cases in the United Kingdom annually costing the health care over £2 billion. A person on anticoagulation (warfarin) and the time spent on its reversal prior to surgery is identifi ed to be a cause not only on patient outcome but also losing the best practice tariff (BPT). Aim: The aim of the study was to establish the impact of this cohort of population had on achieving the BPT and how we could improve it. \ Materials & Methods: Retrospective data was collected over a period of 12 months using the national hip fracture data base (NHFD). A percentage of 10% of the identifi ed cohort was delayed to theatre due to high international normalized ratio (>1.5) and failed to achieve BPT. This cost the trust a loss of around £43,200. Results: Introduction of a simple hand held warfarin testing device (cost only £800/-) in accident and emergency was done and appropriate patients had an instant INR check. If INR >1.5 a stat 2 mg intra venous Vit K (IVK) is initiated and INR was rechecked at six hrs and if indicated further IVK is administered. Conclusion: Using this simple device and its introduction in the A&E department, we can avoid the time lost for the anticoagulation reversal. This will mean improved patient care and compliance with BPT and can be achieved in this cohort of NOF fracture patients.

Biography

E-mail: rthondickal@gmail.com